Medullary Thyroid Cancer

Medullary thyroid cancer is a rare form of thyroid cancer caused by a defect in the RET gene. It starts in the parafollicular C cells of the thyroid gland, which secretes the calcitonin hormone. Calcitonin helps regulate calcium levels in the body. Up to 25 percent of medullary thyroid cancer diagnoses are hereditary. MTC can also be associated with other endocrine tumors such as Multiple Endocrine Neoplasia (MEN) 2A and 2B, which is a hereditary endocrine tumor.    

Symptoms

There are often no symptoms of medullary thyroid cancer, early on. When symptoms do occur, they may include:

• A lump in the neck  
• The feeling of a lump when swallowing
• Hoarseness
• Enlarged lymph nodes

Diagnosis

Medullary thyroid cancer diagnosis will begin with a physical exam and review of your child’s full medical history. In addition, our physicians may use a variety of diagnostic tests including:

• Blood tests to measure the calcitonin hormone and carcinoembryogenic antigen (CEA) levels.
• Ultrasound, a radiation-free imaging technique, which uses high-frequency soundwaves to capture images of your child’s thyroid and lymph nodes.
• Fine needle aspiration biopsy may be used to extract cells from the thyroid and any abnormal lymph nodes for further examination. 

Treatment

At Texas Children’s Hospital, treatment plans are tailored to your child’s individual needs. Medullary thyroid cancer treatment may include:

• Surgery: A total thyroidectomy (removal of the entire thyroid gland) is the primary treatment for medullary thyroid cancer. Often, removal of the lymph nodes of the neck is performed at the time of thyroid surgery or thereafter. These surgeries should be performed by high-volume surgical teams, such as our Thyroid Program Surgical Team, to achieve the best possible outcomes.
• Thyroid medication: After surgery, your child will be treated with hormone replacement medication.